<i>Corynebacterium diphtheriae</i> Outbreak in Migrant Populations in Europe
Andreas Hoefer, Helena M. B. Seth-Smith, Féderica Palma, Stefanie Schindler, Luca Freschi, Alexandra Dangel, Anja Berger, Joshua C D'Aeth, Rebecca Cordery, Enrique Delgado-Rodriguez, Eva Grüner, Domenica Flury, Vladimira Hinić, Julian Kofler, Reto Lienhard, Rob Mariman, Oliver Nolte, Adrian Schibli, Julie Toubiana, Marianna Traugott, Stéphanie Jacquinet, Alexander Indra, Norman K. Fry, Daniel Palm, Andreas Sing, Sylvain Brisse, Adrian Egli
Abstract
BACKGROUND: infection was observed in reception centers for migrants in Europe beginning in the summer of 2022. Most of the cases were cutaneous, although some respiratory cases as well as one death were reported. A pan-European consortium was created to assess the clinical, epidemiologic, and microbiologic features of this outbreak. METHODS: infection that were reported in 10 European countries from January through November 2022. Data regarding countries of origin and transit routes were obtained from interviews with the patients. Whole-genome sequencing and antimicrobial-susceptibility testing were performed on bacterial isolates that were obtained from the patients. The phylogenetic relationships of the isolates and their antimicrobial-resistance genes were evaluated. RESULTS: were resistant to penicillin but were susceptible to amoxicillin. On the basis of the genomic variation within the four genetic clusters, their most recent common ancestors were estimated to have existed between 2017 and 2020. CONCLUSIONS: infections among migrants is a cause for concern, particularly given that antimicrobial-resistance phenotypes threaten the efficacy of first-line treatments. (Funded by the Bavarian State Ministry of Health, Care, and Prevention and others.).